Dual eligibility - Study guides, Class notes & Summaries

Wellcare Exam (2024) || Complete Questions and Solutions (Rated A+) Wellcare Exam (2024) || Complete Questions and Solutions (Rated A+) Business Required Document (BRD) - ANSWER - written by business analyst (BA); created when new CMS regs come out, DTRR comes to us daily, read and apply Functional Specific Document (FSD) - ANSWER - detailed doc w/tables, names of files. etc. Accumulation Files - ANSWER - DSNP are excluded, MOOP accums sent daily to PBM, 9M layout format; outbound is a...

What does IDEA stand for - ANS Individuals with Disabilities Education Act What does ESSA (Title III) stand for - ANS Every Student Succeeds Act Which Requirements are included in Title III of ESSA - ANS Consistent methods for eligibility of EL instruction services, parent and family communication, assess ELs in native language Placement of ELs should be - ANS tied to their age, grade, and ability to access grade-level content Placement of ELs should not be - ANS ...

Since its inception, Medicaid (also called Title 19 of the Social Security Act) was originally designed to finance health care services for the indigent, and therefore it has been almost entirely a tax-payer funded program. From the very beginning, Medicaid has been what we call a means-tested program. What does that mean? - ANS -Eligibility depends on financial resources -Each state administers their own Medicaid program under -Federal guidelines, and Medicaid is jointly financed by ...

AHIP Practice Questions and Answers 100% Pass Different ways to get Medicare - Correct Answer ️️ -- Medicare Cost Plans (some also include Part D) - PACE Plans (includes Part D) - Medicare-medicaid plans (includes D) Medicare COST PLANS - Correct Answer ️️ -- NOT an MA (part C) plan - only available in certain areas of the country - can enroll w/ B but not A - if you have A&B, and go out of network, services will be charged as A&B standards - can join anytime plan is accepting ...

2023 UHC certifications ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Which statement is true about provider information on the Chronic Condition Verification Form? - CORRECT ANSWER The provider indicated on the form does not have to be contracted with the plan. Which statement is true about the Medicaid program? - CORRECT ANSWER Benefits vary from state to state. Which statement is true of D-SNP members? - CORRECT ANSWER Members who ...

2023 Dual and Chronic Condition Special Needs Plans (D-SNP C-SNP) Assessment UHC Question and answers already passed 2023/2024 What are Dual Special Needs Plans (D-SNP)? *Medicare Advantage Plans uniquely designed for consumers enrolled in either Medicare or Medicaid. *Medicare Advantage Plans uniquely designed for Medicare consumers with specific long-term illnesses. Medicare Advantage Plans uniquely designed for Medicare consumers residing in contracted Skilled Nursing Facilities. ...

Medicaid is a means-tested program - ️️Eligibility depends on financial resources Each state administers its own Medicaid program under federal guidelines, and Medicaid is financed by both state and federal governments Automatically qualify for Medicaid - ️️1. Families with children receiving support under the Temporary Assistance for Needy Families (TANF) program 2. People receiving Supplemental Security Income (SSI), which includes the elderly, blind, and disabled with low inco...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 5 | Questions and Verified Answers| Grade A| 100% Correct Q: Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? Answer: All of these Q: Dual-eligible and LIS beneficiaries that are not at-risk may use a Dual-Eligible SEP once per each of the ______ calendar quarters only. (Select all that apply.) Answer: a. First b. Second c. Third Q: An...

When verifying a Dual Eligible Special Needs Plan (D-SNP) beneficiary's Medicaid eligibility through the Ascend Medicaid search tool, you should: - Answer Both When prospective Wellcare members check online for the status of their submitted application, which element is optional? - Answer Confirmation number Grievance procedures are separate and distinct from initial determination and appeal procedures. - Answer True

CalMHSA Medi-Cal Peer Support Certification Exam adult an individual who is 18 years of age or older beneficiary/recipient an individual who receives peer services from a Medi-Cal Peer Support Specialist California Mental Health Services Authority (CalMHSA) the certifying entity approved by the California Department of Health Care Services (DHCS) to certify peer support specialists, peer support specialist training entities, and peer support specialist continuing education provider...